Thursday, February 26, 2015
Letters of support for HB65 pour in from families across KY
I would like to urge each of you to become familiar with and support the passage of HB65 - sponsored by Representative Tom Burch. This bill, relating to court-ordered outpatient mental health treatment, would vastly improve our current system of treating the mentally ill, which is to "warehouse" them in jails when they refuse to be treated.
As the parent of a 36-year old daughter who was diagnosed with Bipolar II and Severe Anxiety Disorder in 2001, I can attest to the toll it takes on those of us who act as caregivers for loved ones who suffer with a mental disorder. More importantly, our current system prevents thousands of mentally ill individuals from receiving the treatment they need in order to deal with their disorder.
Please consider the financial savings that can be realized by having a "system" in place to treat those who, because of their illness, are unable to commit themselves to treatment. Rather than "storing" these individuals in jails, where they cost the taxpayers huge sums of money, do not receive treatment and, when released, find themselves back on the streets where they are soon re-arrested and the cycle continues, let's establish an Assisted Outpatient Treatment (AOT) System which works to help those who suffer from these horrible diseases.
I urge you to let Kentucky follow the lead of North Carolina, New York, Ohio and California in providing Court Ordered Assisted Outpatient Treatment for our mentally ill. Treatment before tragedy...It's the right thing to do.
Sincerely,
Larry C. Souder
Colonel, USAF, Retired
Tuesday, February 24, 2015
My daughter is missing and we need your help -- please pass HB65!
M I S S I N G
IF YOU HAVE INFORMATION ABOUT (ELIZABETH L. MORRIS)
PLEASE CALL KNOXVILLE LAW ENFORCEMENT at (865) 215-7212
OR CONTACT ELIZABETH'S MOTHER AT (270) 217-6637
Date Missing: (Since 10/11/14)
Date of Birth: (04/15/81)
Age: (33)
Sex: (Female)
Height: (5 ft. 11 inches)
Weight: (250 lbs.)
Eyes: (Hazel)
Hair: (Brown Shoulder Length, Curly,
Race: (Caucasian)
Complexion: (Fair)
Clothing: (When last seen she was wearing a long brown coat with fur
collar and flip flops.)
(Left home without money, food or telephone.)
(Mother wants to help her daughter with money, insurance card and an apartment. Elizabeth doesn’t have to come home if she doesn’t want to. Mother is very worried about her safety and well-being. She isn’t in trouble with the law. She may be a little confused. Please help.
WHAT WOULD YOU DO IF ELIZABETH WERE YOUR DAUGHTER?
My name is Janis Morris from Paducah, Kentucky. My daughter Elizabeth Lauren Morris had the onset of her severe brain disease in 2009. After 3 years, she was diagnosed with of psychotic thinking and symptomatic of paranoid schizophrenia. She has delusions and hallucinations. To make this diagnosis even worse she has anosognosia. There is damage to her brain as a result of this illness preventing her ability to comprehend that she is ill.
· She believes that the voices are God telling her what to do.
· She believes that the hallucinations are God punishing her for her sins.
· She believes that I am evil because the voices have told her so.
· She thinks that the police and I am trying to kill her
· She resented my being granted guardianship and resented my trying to get her to take her medications and stay in treatment. She baptized an individual at Western State Hospital in the shower. I was told that she baptized a man in Nashville, since she has been missing prior to his exploiting her for sex and then making her sleep outside on the door mat.
She did not want to apply for social security disability. She said, “I am smart, I have a degree and I have 10 fingers and 10 toes, so I can work and don’t need disability.” One thing about it, in spite of her illness she still tried to work and wanted me to be proud of her just like you are proud of your children.
Her illness was not that of a heart defect, her illness was not that of kidney failure or any of the physical illness that our society is working so hard to correct. No her illness is a disease of the brain. A brain disorder. I think we all know that the brain is a real important organ too. Right? Then why has our society treated it as if those individuals with mental illness are outcasts? This is something we all need to think about. I too was guilty of this thinking, prior to my daughter’s illness.
Due to her failing to realize her illness and her insistence that she would not take her medication, she left home in September 2014. My daughter last called me on October 11th of 2014. Elizabeth only made a brief statement that she wanted to make things right with me because she was getting ready to go to heaven. Then she hung up the phone. Elizabeth was last seen in Knoxville, TN and presently the police and private investigators have not had any luck in locating her. I am worried about her, how she is being treated, if she warm or hungry. I have spent thousands of dollars and have done everything in my power to find her and see that she gains the medical attention she needs with no success.
When Elizabeth was on her medication, she was much better. Elizabeth was so afraid when she was not on her medications. Elizabeth would have qualified HB65 if it were law. If it had been in place, Elizabeth would probably be in a safe and warm place surrounded by those that love her. I love and miss her so much.
Put yourself in my shoes. What if Elizabeth was your child? Or your sister? What would you do?
I believe that HB 65 would benefit individuals such as Elizabeth that are mentally ill with anosognosia. We need your help!
Monday, February 23, 2015
Mike Beard Shares his Support for HB65 with Kentucky Legislators
My name is Michael David Beard and I'm an active volunteer for NAMI Lexington. I'm 43 years old and have
suffered from a mental illness the majority of my life.
I am here to day to
speak about HB65 because it reminded me of the early days of my diagnosis.
Bad things
can happen when you are sick.
In 1986, I entered
the hospital for the first time. After that, it was a long road to recovery for
me.
Almost 25 years later, I now represent a successful organization that gives me a whole new life.
Almost 25 years later, I now represent a successful organization that gives me a whole new life.
Today, I give my time to Participation Station and I share my
story called IN OUR OWN VOICE. I am facilitator and I am a consumer of mental health services. I am also diagnosed with major depression and paranoid schizophrenia.
One of my favorite pastimes is playing on a men’s softball
team.
My mission today is to explain why HB65 is important. It is
about moving involuntary patients from the hospital to outpatient care.
HB65 contains a new pathway to treatment prior to involuntary
hospitalization.
If someone like myself who does not have insight, HB65 would
be very helpful.
My recovery has included hospitalization, medication and
counseling. I've been hospitalized over 12 times in the span of 20 years where
I was classified as a revolving door patient. I appreciate as much support as I need.
I wish this outpatient treatment option had been available
for me years ago.
Please join me in supporting HB65.
GG Burns, Mike D. Beard and Faye Morton
HB65 would have given my son Tim a RIGHT to treatment -- It will save lives!
My name is Faye Morton, I live in Lexington with my husband of 61 years and together we parented a son who lived with serious paranoid schizophrenia. I would like to share our story and ask your support to improve outpatient mental health services in Kentucky.
When our son, Tim, was 18 and just graduated from high school, he became terrified by the sudden onset of persistent delusions that he had royal blood and could read peoples’ minds. He begged for help and was hospitalized for six weeks. We were advised that a careful regimen of medications over time and staying busy would reduce the delusions and allow him to have a meaningful life.
Faye Morton with her son Tim in 1977 |
After he returned home he went back to work, and although his symptoms were reduced by heavy medication he determined that he was well so he stopped taking his medicine.
He required hospitalization very quickly for another round of treatment. This pattern continued, working odd jobs for the first few years in between hospital visits and at times, living on the street, he lived this way for the next 36 years. While he voluntarily went to the hospital the first few times, over the years he received needed treatment only through court ordered involuntary hospitalization by petition 37 times. He was discharged, at times, to the street.
He required hospitalization very quickly for another round of treatment. This pattern continued, working odd jobs for the first few years in between hospital visits and at times, living on the street, he lived this way for the next 36 years. While he voluntarily went to the hospital the first few times, over the years he received needed treatment only through court ordered involuntary hospitalization by petition 37 times. He was discharged, at times, to the street.
In 2007, after another hospitalization, Tim began to receive services through a mobile outreach team, which included housing support. Over the next three years he was visited at least three times a week and transported to the Comprehensive Care Center as needed, but he refused the medications that were effective in the hospital. His physical and mental health continued to deteriorate and he had to be hospitalized during this time, against his will.
In early January 2011, he fled, frightened by his delusions and disappeared for two weeks. I filed a missing person’s report and a sheriff in Texas called to say that Tim was there. After returning to Lexington, the outreach team continued to visit him, witnessing his decline because he had been without medication for several months and so paranoid that he stopped eating—convinced that the food he had purchased was poisoned. With his health greatly compromised by self-neglect, he was hospitalized again by court order, in March 2011.
During that period of treatment he showed great improvement in a short amount of time and was discharged in two weeks. At the discharge plan meeting, his psychiatrist ordered that he should return to his apartment and receive his medication as prescribed. If he refused, his case manager was to obtain a court order for hospital readmission.
For three years Tim received prescribed outpatient treatment and did not require hospitalization. His treatment made a positive impact on his quality of life in spite of the serious deterioration of his health after decades of neglect.
Tim slowly improved and he and I wondered at the transformation he was undergoing and his ability to experience the joy of thinking rational thoughts and the simple pleasure of having peace. Although, when we visited he would explain that he was well and that he wanted to stop taking his medicine. He said that his only pain was my unwillingness to accept that he did not need medicine. He was able to express his frustration with me although he willingly went to his appointments for his treatment. This lack of insight, known as anosognosia, is a common symptom of schizophrenia.
My husband and I are grateful for the individualized level of care that Tim received during the last three years of his life. He died March 27, 2014. He was 56 years old and had lived nearly 36 years with "untreated" mental illness. We found him in his apartment; he had died in his sleep from an apparent heart attack. Some people say that our son had a right choose to live his life without treatment. I know that for many people like my son, treatment works.
HB65 would help the young people who are diagnosed today receive the treatment that could save their lives and give them a quality of life that we had only imagined being possible for our Tim.
Saturday, February 21, 2015
SAVE LIVES - PASS HB65, so people can have the right to be in their right mind!
Speech to support HB65, which was "unanimously" passed out of House and Welfare Committee on Thursday, February 12, 2015
Imagine your son or daughter has a cancer in their brain.
Imagine their doctor said, “the cancer is treatable and the prognosis with medication and therapy is good!” Yet, imagine your son or daughter’s brain cancer does not allow them to understand they have an illness and they simply refuse to ride with you to see a doctor … to discuss their treatment options. Or even when you “bribe them to see a doctor” they say, “I hope you hang yourself – I don’t have a illness” – and the doctor must leave the room?
Imagine that even if you were able to obtain guardianship over your son or daughter’s fiancées – you are still unable to help them access the treatment they need to survive or to slow down the deterioration of the cancer. What would you do?
Imagine that on countless occasions, licensed medical providers said your only option was to set your very ill son/daughter up to fail, so they will end up in jail. This sounds barbaric and inhumane, right?
This is exactly what it is like, in attempting to help our ill family members with serious mental illnesses that have a symptom known as AH-no-sog-NO-sia. {Anosognosia is a neurological syndrome is believed to be the single largest reason why individuals with mental illness do not take their medications.}
When a person’s brain disease deteriorates, they lack capacity to understand their "need for treatment" or informed consent. They deserve a full capacity evaluation, so they can potentially "qualify" for a "right to be involuntarily stabilized/treated" OUTPATIENT, in the community – not punished in jail, where they most certainly will lose their civil liberties.
{For those individuals and state/federal-funded agencies that state that HB65, is unconstitutional … I challenge those individuals to walk a mile in my son’s shoes. Forty-five states have court-ordered outpatient treatment laws - some over 40 years old. The U.S. Supreme Court has never found any of these laws unconstitutional.}As an advocate, I receive many calls from across from Kentucky. These families have been traumatized from a system designed only for those well enough to advocate for themselves. Families across Kentucky are so broken they have become voiceless.
Imagine your beautiful daughter has this same brain disease I described earlier and disappears for months? Yet even after you file a missing person report and spend thousands on private investigators, all you learn is your daughter has been spotted in another state and has been sexually victimized.
There isn’t time today for Janis Morris, a mother from Paducah, horrific testimony, nor from Mothers like Faye Morton – a tireless NAMI advocate who advocated for assisted outpatient treatment for her son Tim over 38 years.
There isn’t time today for Janis Morris, a mother from Paducah, horrific testimony, nor from Mothers like Faye Morton – a tireless NAMI advocate who advocated for assisted outpatient treatment for her son Tim over 38 years.
Faye’s son died March 29, 2014.
Kentucky’s law failed Tim allowing him to suffer unnecessarily with paranoia and delusions to the point he was too afraid to eat!
Tim died, like so many others will – but you have the power to change this, by passing HB65 today.
Faye Morton and her son Tim in 2010. |
Please pass HB65, so people most at risk can receive treatment before tragedy!
Pass HB65, so people can have the right to be in their right mind!
Pass HB65, so people can have the right to be in their right mind!
GG Burns, has advocated for Assisted Outpatient Treatment for 5 years and has supported 3 bills in the Kentucky legislature. "Without treatment" my son will continue to be denied his civil liberties! I would like to see my son achieve his goals, to be in his right mind. But without ‘sweeping’ changes in Ky's public policy, I fear he will die young or end up in prison all from a "treatable disease".
"Mental illness is not a communicable disease", Dante Murry's support for HB65
I'm honored to share a guest blog post written by Dante Murry, regarding his support of HB65 and how treatment and NAMI has saved his life. Thank you Dante for your advocacy, bravely and for your time to help others understand the importance of treatment before tragedy, GGB.
Hello my name is Dante Murry, I have been an advocate for National Alliance on Mental Illness NAMI, for 7 years.
Before I gave my support for House Bill 65, I asked many questions to gain a clear understanding because as a consumer, I felt that NAMI Louisville members needed to question policies and have accountability for those we represent.After reviewing all the facts, it was only logical for me to support HB65. I felt joy in my heart, as I witnessed HB65 being passed "unanimously" out of House and Welfare Committee on Thursday, February 12th. I feel very strongly about the many provisions and protections for the person’s afflicted with acute mental illnesses and those who endure the daunting task of caring for their children, fathers, mothers, or friends with severe symptoms of anosognosia.
I know that mental health advocates like Dr. Sheila Shuster, GG Burns, Representative Tom Burch, Sarah Kidder and others are working with legislators in Kentucky to change the nature of assisted outpatient treatment (AOT), the process by which a court orders a patient to follow a treatment plan while living in the community, instead of a residential treatment facility.
As I understand, Kentucky already has an AOT statute that is relatively narrow in its scope and requires a high threshold for establishing a court-approved treatment plan. Chairman Tom Burch of Louisville, has proposed a bill that would make it possible for family members and mental health professionals to get comprehensive and effective treatment before tragedy in the community for people suffering from severe and persistent mental illnesses.
HB65 will provide an avenue for families to get help for their loved ones during the darkest times of their lives.
From my personal experience, families often feel like they have no options and are not receiving enough help from doctors, the legal system, and other community mental health agencies.
I really believe that HB65 is the best overall course of treatment for loved ones suffering from acute mental illnesses and should be heard in the Kentucky Senate Health and Welfare Committee.
My personal story with mental illness began at Wellstone in 2005. This was a traumatic experience for me and my family. Before I experienced my psychotic episode, I worked at a large corporate company full time for over 12 years. I was involved in my faith, volunteered at the YMCA youth programs, and attended Webster University to complete my dual masters program (Human Resources and Management Leadership). My experiences opened my eyes to the possibility that any of us could be afflicted with mental health issues.
Stigma was also a new experience for me because unlike racism, this new prejudice comes from all sides of humanity. I found myself hitting a glass ceiling and was placed in a job position of isolation from my peers. I was encouraged to work odd hours (twilight from Thursday to Monday).
I felt like I had been quarantined. It seemed that most people believe that if you quarantine the mentally ill from the masses, the illness will not spread. Mental illness is not a communicable disease.
Honestly, education about mental health illness is seldom discussed in the African American community. As an African American consumer, my real opportunity to learn about my illness started with an organization named NAMI . My father and mother struggled with understanding my mental illness. I didn’t understand it either. Family to Family Support programs helped me and my parents to forge a new bond. The bond resulted in a better understanding about my illness and its effects. Unfortunately, most families are ignorant about mental health issues until it comes to their front porch.
Louisville Kentucky prison system examined in PBS film |
I have coped with the realities of my disorders while recovering and reclaiming a productive life with meaning and dignity. I want to share the ups and downs of my recovery and help others to learn from my experiences (does and don’ts). I have been empowered by NAMI volunteering opportunities, NAMI support groups like Connection, mental health conferences, and Peer-to-Peer classes of which I have facilitated as a Mentor.
One of my success stories is that I am now a certified Kentucky Peer Support Specialist. Personally, I never thought a recovery process could help me with my mental illness. It is a long, difficult journey each day dealing with mental illness. I can relate to others because I live it each day. In my opinion, each consumer needs to feel that there is hope and support for their recovery process by hearing and seeing positive experiences.
NAMI has been such a positive impact on me that I was nominated to be a NAMI Louisville board member in 2014. As a result of the NAMI Peer to Peer Mentor training, I was able to prepare myself to enter into the workforce. Currently, I work part-time for Seven Counties Services as a Peer Support Specialist. I believe that the NAMI training program called IOOV (In Our Own Voice) prepared me to speak publicly to large audiences like the Story Slam Competition by Actors Theater in Louisville, KY. I believe that the NAMI support groups were instrumental in building my confidence and dignity as a person.
I am NOT my illness, I just have an illness! With treatment, my illness is manageable, allowing me to enjoy my life in the community.
Thursday, February 12, 2015
Thursday, February 5, 2015
Kentucky Proposes NEW outpatient treatment bill – HB65, Representative Tom Burch
Please join me in thanking NAMI KY for supporting this important legislation. A special thanks to Dr. Sheila Schuster of the Kentucky Mental Health Coalition, (KMHC) and to Representative Tom Burch for making HB65 a reality.
In 2010, I started a blog campaign to advocate for a law, (similar to what other states had) that would assist an individual into treatment before they became dangerous to self or others, or before their lives were ruined forever … as our son and family has experienced the past 10 years.
Two years ago, in 2012-13, Rep. Burch and Sen. Denton both sponsored identical bills that strengthen and lengthen the current community based outpatient agreed order … under the KRS 202A.081. (This law has been on the books 32 years, but has been underfunded and rarely utilized.)
Talking Points and Summary for HB65 …
Two years ago, in 2012-13, Rep. Burch and Sen. Denton both sponsored identical bills that strengthen and lengthen the current community based outpatient agreed order … under the KRS 202A.081. (This law has been on the books 32 years, but has been underfunded and rarely utilized.)
In 2014, after many testimonies to the Kentucky interim joint committee on health and welfare, 2 additional bills were sponsored. They were HB 221 and SB 50.
At the legislative advocacy day in 2014, NAMI KY asked their legislators to combine both bills and pass a compressive bill that would help people before they reached KY’s strict inpatient criteria. NAMI KY, NAMI LEX, BH providers, advocates, family members and individuals living with a brain disease diagnoses … as well as Dr. Sheila Shuster (KMHC); worked through many tedious meetings, agreeing on language. HB65 is essentially the product of those meetings.
HB65 is in 2 parts. In the first section, Part 1 [Sections 1 – 3]: the language strengthens the already-existing law (KRS 202A.081) which permits persons involuntarily committed to the hospital to be discharged on the condition that they agree to – and comply with – court-ordered outpatient treatment. In section (1 an alternative sentencing is provided, with mechanism that will help connect the system to the patient. In (2) AOT allows someone to live in the community under a court order. Other additions to the first section are as follows:
• Added … a peer support specialist or other supportive person present and “MAY” be asked to support the patient during this process.
• Another addition added to HB 65 is: it renames this outpatient commitment process “a patient agreed order”.
• In [Section 1 (4); p. 1] Requires the Department of Public Advocacy (DPA) to assign an alternative sentencing social worker to develop a treatment plan in collaboration with a community mental health center.
• [Section 1 (6); p. 2] Requires the court to appoint a case management service or team employed by a community mental health center to monitor treatment and the patient’s compliance with the treatment.
• [Section 1 (7); p. 2] It requires that the case management service or team report on the person's functioning, recommend community support services, and assist the person in applying for social services. [This is an important section, as it connects the CMHC to the patient, that may be unable to access housing or basic needs without a MSW.]
• [Section 1 (7); p. 2] It requires that the case management service or team is available 24/7 and is adequately trained.
• [Section 1 (8); p. 2] It requires that treatment providers use evidence-based practices as defined.
• [Section 1 (9); p.2-3] Provides that failure to abide by the treatment plan may result in the patient being re-hospitalized if the hospitalization criteria are met, procedures are initiated via affidavit by the case management service or team, and that a mental health examination of the patient take place at a community mental health center.
• [Section 1 (10); p. 3] With due process, permit the agreed order to be extended up to 3 additional orders of 60 days (total of 180 days) each after a hearing is held, with the same procedures and safeguards as for the initial hearing.
• [Section 1 (11; p. 3] requires that services provided to the patient under the agreed order are covered by Medicaid.
• [Section 1 (12) p, 4] Requires that the courts report each patient agreed order to the Cabinet. [This is very important, because in all my research as to why people can’t access OT … I learned that the state has never collected adequate data on the number of people who had actually received a community based outpatient agreed order.]
SHORT VERSION SUMMARY OF 2nd SECTION of HB65:
This bill creates new “outpatient” language and makes it possible for a provider or family member to commit an individual, who has anosognosia to outpatient services. This is the new section that would provide a person treatment before tragedy instead of waiting until they are homicidal, suicidal or become a felon; sentenced to long-term imprisonment. (In which case, they will lose all civil rights and not likely to receive treatment.)
New outpatient criteria in Section 6:
• 55% fewer recipients engaged in suicide attempts or physical harm to self
• 47% fewer physically harmed others
• 46% fewer damaged or destroyed property
• 43% fewer threatened physical harm to others
• Overall, the average decrease in harmful behaviors was 44%
• 74% fewer participants experienced homelessness
• 77% fewer experienced psychiatric hospitalization
• 56% reduction in length of hospitalization
• 83% fewer experienced arrest
• 87% fewer experienced incarceration
• 49% fewer abused alcohol
• 48% fewer abused drugs
• Number of individuals exhibiting good adherence to meds increased 51%.
• The number of individuals exhibiting good service engagement increased 103%.
Consumer Perceptions Were Positive after Outpatient Treatment
• 75% reported that AOT helped them gain control over their lives
• 81% said AOT helped them get and stay well
• 90% said AOT made them more likely to keep appointments and take meds.
• 87% of participants said they were confident in their case manager's ability.
• 88% said they and case manager agreed on what is important to work on.
Info from: March 2005 N.Y. State Office of Mental Health “Kendraʼs Law: Final Report on the Status of Assisted Outpatient Treatment.”
At the legislative advocacy day in 2014, NAMI KY asked their legislators to combine both bills and pass a compressive bill that would help people before they reached KY’s strict inpatient criteria. NAMI KY, NAMI LEX, BH providers, advocates, family members and individuals living with a brain disease diagnoses … as well as Dr. Sheila Shuster (KMHC); worked through many tedious meetings, agreeing on language. HB65 is essentially the product of those meetings.
HB65 is in 2 parts. In the first section, Part 1 [Sections 1 – 3]: the language strengthens the already-existing law (KRS 202A.081) which permits persons involuntarily committed to the hospital to be discharged on the condition that they agree to – and comply with – court-ordered outpatient treatment. In section (1 an alternative sentencing is provided, with mechanism that will help connect the system to the patient. In (2) AOT allows someone to live in the community under a court order. Other additions to the first section are as follows:
• Added … a peer support specialist or other supportive person present and “MAY” be asked to support the patient during this process.
• Another addition added to HB 65 is: it renames this outpatient commitment process “a patient agreed order”.
• In [Section 1 (4); p. 1] Requires the Department of Public Advocacy (DPA) to assign an alternative sentencing social worker to develop a treatment plan in collaboration with a community mental health center.
• [Section 1 (6); p. 2] Requires the court to appoint a case management service or team employed by a community mental health center to monitor treatment and the patient’s compliance with the treatment.
• [Section 1 (7); p. 2] It requires that the case management service or team report on the person's functioning, recommend community support services, and assist the person in applying for social services. [This is an important section, as it connects the CMHC to the patient, that may be unable to access housing or basic needs without a MSW.]
• [Section 1 (7); p. 2] It requires that the case management service or team is available 24/7 and is adequately trained.
• [Section 1 (8); p. 2] It requires that treatment providers use evidence-based practices as defined.
• [Section 1 (9); p.2-3] Provides that failure to abide by the treatment plan may result in the patient being re-hospitalized if the hospitalization criteria are met, procedures are initiated via affidavit by the case management service or team, and that a mental health examination of the patient take place at a community mental health center.
• [Section 1 (10); p. 3] With due process, permit the agreed order to be extended up to 3 additional orders of 60 days (total of 180 days) each after a hearing is held, with the same procedures and safeguards as for the initial hearing.
• [Section 1 (11; p. 3] requires that services provided to the patient under the agreed order are covered by Medicaid.
• [Section 1 (12) p, 4] Requires that the courts report each patient agreed order to the Cabinet. [This is very important, because in all my research as to why people can’t access OT … I learned that the state has never collected adequate data on the number of people who had actually received a community based outpatient agreed order.]
The most important part of HB65 is public safety. It will save lives.
“It’s better to be ordered to receive medical help, access to resources, housing, etc., in a least restrictive environment ... than forced to become a criminal, trapped in jail/prison where a person will lose all civil rights, and will still not receive treatment.”
SHORT VERSION SUMMARY OF 2nd SECTION of HB65:
This bill creates new “outpatient” language and makes it possible for a provider or family member to commit an individual, who has anosognosia to outpatient services. This is the new section that would provide a person treatment before tragedy instead of waiting until they are homicidal, suicidal or become a felon; sentenced to long-term imprisonment. (In which case, they will lose all civil rights and not likely to receive treatment.)
New outpatient criteria in Section 6:
Section 6. New
· No person shall be subjected to
court-ordered AOT unless she would otherwise:
o 1) present a threat of danger to herself or others;
o 2) cause severe mental, emotional, or physical harm;
o 3) have significantly impaired judgment, reasoning, functioning, or
capacity to recognize reality; AND
o 4) have a substantially diminished ability to make informed decisions
regarding his or her need for sustained medical treatment.
o Furthermore, the patient must be unlikely to adhere to outpatient
treatment on a voluntary basis based on a QMHP’s
· 1) clinical observation;
· 2) review of treatment history, AND
·
The AOT must be the least
restrictive alternative mode of treatment available.
Section 7. New
·
The QMHP who examines the
respondent must provide a written treatment plan that includes “reasonable
opportunities” for the involvement of both the patient and anyone else she
wants on board, any advance directive already executed by the patient, and evidence-based
practices.
Section 8. New
·
At the hearing, respondent shall be:
o Represented by counsel
o accompanied by a peer support specialist or “other person in a support
relationship” AND
o “Afforded an opportunity to present evidence, call witnesses on his or
her behalf, and cross-examine adverse witnesses.”
·
The court may conduct the hearing in the respondent’s absence
·
The QMHP who recommends
court-ordered AOT shall testify at the hearing.
·
The court must find clear and convincing evidence that the
patient meets the criteria in Section 6 of this bill to order AOT, but the
court is not compelled to do so. In other words, the evidence that the
respondent needs AOT must be clear and convincing to even consider issuing the
order. The court can still choose not to
issue the order even with clear and convincing evidence.
Section 9. New
·
After ordering AOT, the court appoints a case management
service or team employed by a CMHC who shall
o Monitor the patient’s
adherence to the order and
o Report to the court
“descriptive of the person’s functioning.”
·
The service or team shall be available 24 hrs/day
Section 10. New
·
Failure to comply “may
constitute” grounds for a physician to order a 72 hour hold.
·
Failure to comply is not grounds for contempt of court.
Section 11. New
·
At any time during the treatment,
the patient may move the court to stay,
vacate, or modify the order.
·
A QMHP may move the court to change the order
o “material change” means an addition or deletion of one of the services
from a treatment plan.
·
Within 30 days of the expiration
of an order, the original petitioner may
petition for an additional period of AOT.
o The procedure is the same as the first petition, except the parties may mutually agree to waive the
hearing.
Section 12. New
·
The services for the order “shall
be authorized by the Department for Medicaid Services [DMS] and its contractors
[MCOs] as Medicaid-eligible services and shall be subject to the same medical
necessity criteria and reimbursement methodology as for all other covered behavioral health services.”
emphasis added.
[Currently, even if treatment programs and resources are available for individuals with brain disease, SMI ... if the patient does not believe they are have symptoms, or has anosognosia, there is little hope they can access services. This in turn, sets the individual and the mental health system up for failure.]
See NAMI Kentucky's sample letter to the Kentuky legislature here:
Danger and Violence Reduced after Outpatient Treatment
• 55% fewer recipients engaged in suicide attempts or physical harm to self
• 47% fewer physically harmed others
• 46% fewer damaged or destroyed property
• 43% fewer threatened physical harm to others
• Overall, the average decrease in harmful behaviors was 44%
• 74% fewer participants experienced homelessness
• 77% fewer experienced psychiatric hospitalization
• 56% reduction in length of hospitalization
• 83% fewer experienced arrest
• 87% fewer experienced incarceration
• 49% fewer abused alcohol
• 48% fewer abused drugs
• Number of individuals exhibiting good adherence to meds increased 51%.
• The number of individuals exhibiting good service engagement increased 103%.
• 75% reported that AOT helped them gain control over their lives
• 81% said AOT helped them get and stay well
• 90% said AOT made them more likely to keep appointments and take meds.
• 87% of participants said they were confident in their case manager's ability.
• 88% said they and case manager agreed on what is important to work on.
Info from: March 2005 N.Y. State Office of Mental Health “Kendraʼs Law: Final Report on the Status of Assisted Outpatient Treatment.”
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